A 4-year-old girl who is an only child stas school. He has never shown much of an interest in interacting with others. He has never used many words which the parents attribute to his isolation as an only child. They tell the teacher he has always done best with a strict schedule and doesn't tolerate changes well. Other children attempt to play with him but his response is to either ignore them or get angry at their advances. The patient described can best be distinguished from Rett disorder because of which of the following?